The PN exam is not a shorter RN exam. It weights Coordinated Care and Basic Care and Comfort more heavily, it tests data collection rather than assessment, and almost every item quietly asks whether the action is inside LPN/LVN scope. Below: the full September 2026 test plan, the scope rules that decide the answer, the Next Gen formats you will meet, and free practice questions.
8
Client Needs areas on the PN plan
18–24%
Coordinated Care — the biggest area
85–150
Items, 5-hour limit
6
Next Gen item formats
Build your practice mix to match these percentages. Most PN candidates over-study pharmacology and under-study Coordinated Care, which is the largest area on the exam.
The single largest PN area. Advocacy, client rights, confidentiality, informed consent, incident reporting, continuity of care, and — tested constantly — what the LPN/LVN may accept, perform, and assign to unlicensed assistive personnel.
Standard and transmission-based precautions, safe handling of equipment, restraint policy, fall and fire safety, medication error prevention, and correct use of personal protective equipment.
Expected growth and development across the lifespan, data collection during pregnancy and the newborn period, aging changes, screening, immunizations, and reinforcing health teaching the RN has started.
Therapeutic communication, coping and defence mechanisms, grief, abuse and neglect indicators, substance use, behavioural management, and cultural and spiritual needs.
Hygiene, mobility and positioning, assistive devices, nutrition and oral hydration, elimination, rest and sleep, and non-drug comfort measures. Weighted more heavily on the PN exam than on the RN exam.
Medication administration by the routes within LPN/LVN scope, dosage calculation, expected and adverse effects, pain management, and monitoring clients receiving established intravenous therapy.
Recognising changes in vital signs and laboratory values, caring for clients before and after diagnostic tests and procedures, and reporting findings that fall outside expected parameters.
Caring for clients with acute, chronic, and life-threatening conditions: fluid and electrolyte imbalance, wound care, ostomy care, oxygen therapy, and recognising a medical emergency early.
When two options are both clinically sensible, the correct one is the one an LPN/LVN may actually do. These five rules resolve most of those items.
If an option says the LPN will 'teach' a brand-new plan of care, it is nearly always wrong. Reinforcing, reviewing, and checking understanding are all inside scope.
Gathering vital signs, intake and output, wound appearance, and client statements is PN work. Interpreting that data into a new nursing diagnosis is RN work.
Expect assignment items where the correct answer is the stable, chronic, predictable client — the unstable, newly admitted, or newly post-operative client stays with the RN.
The LPN/LVN may assign hygiene, ambulation, positioning, intake and output, and vital signs on stable clients to unlicensed assistive personnel — nothing that requires nursing judgement.
'Notify the registered nurse' is a correct answer when the finding is new, worsening, or outside parameters — and a wrong answer when the item wants an immediate safety action first.
| NCLEX-PN | NCLEX-RN | |
|---|---|---|
| Exam length | 85–150 items, 5 hours | 85–150 items, 5 hours |
| Largest content area | Coordinated Care, 18–24% | Management of Care, 15–21% |
| Cognitive focus | Data collection, reinforcing the plan of care | Assessment, analysis, independent judgement |
| Next Gen items | Case studies and stand-alone NGN items included | Case studies and stand-alone NGN items included |
| Basic Care and Comfort | 7–13% — heavier | 6–12% |
| Scoring | Adaptive, pass/fail against the PN passing standard | Adaptive, pass/fail against the RN passing standard |
Written in current PN item style — scope, delegation, dosage, precautions and data collection. Answer first, then open the rationale.
The charge nurse is assigning clients on a medical unit. Which client is most appropriate to assign to the LPN/LVN?
Answer: The client with stable COPD receiving scheduled nebulizer treatments.
The LPN/LVN cares for clients whose condition is stable and whose outcomes are predictable. New-onset chest pain and the immediate post-thyroidectomy client are unstable and need registered-nurse assessment; initial teaching about a new device must be initiated by the RN, although the LPN/LVN may reinforce it afterwards.
Study tip: Stable + predictable = LPN. New, unstable, or first-time teaching = RN.
Which tasks may the LPN/LVN assign to unlicensed assistive personnel caring for stable clients? (Select all that apply.)
Answer: Vital signs, assisted ambulation, intake and output, and a bed bath.
Unlicensed assistive personnel may perform standard, unchanging tasks on stable clients. Reinforcing teaching requires a licensed nurse, and evaluating the effect of a medication is nursing judgement that cannot be assigned.
Study tip: If the task needs teaching, judgement, or evaluation, it cannot go to a UAP.
Before administering digoxin 0.125 mg orally to an older adult, which finding requires the LPN/LVN to hold the dose and notify the registered nurse?
Answer: Apical pulse of 52 beats per minute.
Digoxin slows conduction, and an apical rate below 60 beats per minute in an adult is the standard parameter for holding the dose and reporting. The blood pressure and potassium are within expected limits; a different-looking tablet should be verified but is not the priority hold parameter.
Study tip: Count the apical pulse for a full minute before every digoxin dose.
A client is admitted with suspected pulmonary tuberculosis. Which action should the LPN/LVN take first?
Answer: Negative-pressure room with an N95 respirator worn on entry.
Tuberculosis requires airborne precautions: an airborne-infection isolation room with negative pressure, the door kept closed, and a fit-tested N95 respirator for every person entering. A surgical mask on the client is used only for transport.
Study tip: Airborne = private negative-pressure room, door closed, N95 on the nurse.
Which actions should the LPN/LVN take when caring for a client on the second day after a total hip arthroplasty with a posterior approach? (Select all that apply.)
Answer: Abduction pillow, hip flexion kept under 90 degrees, and a raised toilet seat.
Posterior-approach precautions prevent dislocation: keep the legs abducted, avoid flexion beyond 90 degrees, and avoid internal rotation and adduction. Low soft chairs force excessive flexion, crossing the legs adducts the hip, and turning is normally toward the unaffected side unless prescribed otherwise.
Study tip: No bending past 90°, no crossing, no twisting inward.
A client newly diagnosed with heart failure says, "I don't see the point in taking all these pills." Which response by the LPN/LVN is most therapeutic?
Answer: "Tell me more about what is making you feel that way."
An open-ended invitation explores the client's feelings and keeps the conversation going. Warning about rehospitalisation is a threat, false reassurance dismisses the concern, and promising a medication change is outside scope and may not be possible.
Study tip: Therapeutic answers explore feelings; they never advise, reassure, or judge.
The September 2026 question pack covers every Client Needs category for both the RN and the PN test plan, including Next Gen case studies, bow-tie, matrix, cloze and highlight items — each with the answer, a full rationale, and a study tip. One payment, yours to keep, refreshed every month.
Every body system carries paged questions, notes, flashcards and labelled diagrams, with the LPN/LVN scope called out where it differs from the RN answer.